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Anchor lead: The state of Maryland takes the lead in reining in generic prescription drug price gouging, Elizabeth Tracey reports

The state of Maryland is to be applauded for stepping into territory the federal government has been unable to navigate with the passage of a law to rein in astronomical price increases of generic drugs. Jeremy Greene, one author of a recent perspective in the New England Journal of Medicine on the law from Johns Hopkins, explains its implications.

Greene: Maryland has just passed into law the first attempt to make price gouging on off patent essential drugs illegal. Most recently the concern has to do with naloxone, of course this crucial drug for dealing with this expanding opioid epidemic, off patent yet the price skyrockets, old, essential medicines are becoming untenably expensive because of a small group of bad actors who recognize the ability to exploit effectively this loophole in American generic drug policy. And the state of Maryland put forward a bill to say not in Maryland.  :33

Greene says the State, healthcare professionals and patients themselves are all empowered to report possible gouging. At Johns Hopkins, I’m Elizabeth Tracey.

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Anchor lead: Scientists have successfully produced a virus from scratch, Elizabeth Tracey reports

Using freely available materials and methods, researchers have revealed the successful recreation of an extinct virus, a relative of smallpox. Andrew Pekosz, a virologist at Johns Hopkins, isn’t joining the chorus of gloom and doom surrounding the news.

Pekosz: We have emerging infectious diseases come around almost every year and for all intents and purposes, those are the same as for instance if someone was releasing a new, engineering virus into the population. So we really shouldn’t be focusing on stopping people from making viruses we should really be improving our ability to deal with these new viruses when they emerge in the human population because if we do that we’ll be able to not only stop these terrorists from using bioweapons but we’ll also be helping ourselves in terms of the naturally occurring outbreaks that happen so frequently to us.  :32

Pekosz notes that a considerable amount of expertise is still required to recreate a functional virus, so he doesn’t look for this to become a common practice. At Johns Hopkins, I’m Elizabeth Tracey.

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view of an aluminum can of sugar free soda

This week’s topics include early adulthood weight gain and outcomes, the dangers of artificial sweeteners, an opioid reduction strategy, and consequences of reduced readmissions.

Program notes:
0:33 Artificial sweeteners
1:33 Really not effective at reducing BMI
2:32 Best to avoid
2:42 Weight gain in mid-life
3:42 Dose dependent negative outcomes
4:42 Decreases risk for type 2 diabetes
5:08 Opioid tapering and cessation
6:10 If they decreased or ceased it decreased pain
7:10 Use of non-opioid analgesics
7:45 Readmissions and mortality
8:45 A priori would have predicted more death
9:35 May help with patient concerns
10:22 End
Related blog: https://podblog.blogs.hopkinsmedicine.org/2017/07/21/artificial-sweeteners-not/
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UnknownThis week’s topics include diet quality and longevity, health and coffee, treating depression, and prostatectomy in early prostate cancer.

Program notes:

0:33 Coffee drinking and longevity
1:33 Over 185,000 people followed in one study
2:32 Can’t advocate for a type of coffee
3:01 Prostatectomy or not in early prostate cancer
4:01 Higher incidence of side effects
5:01 What kinds of means are used to monitor?
5:40 Treatment of refractory depression
6:40 Added atypical antipsychotic
7:40 Adding another agent that works differently
8:32 Quality diets and longevity
9:32 Substitute healthier foods
10:55 End

Related blog: https://podblog.blogs.hopkinsmedicine.org/2017/07/14/more-joy-for-coffee-drinkers/

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Anchor lead: How can more appropriate antibiotic use be implemented? Elizabeth Tracey reports

One in five hospitalized adults who received antibiotics experienced an adverse event related to their use, a recent study of nearly 1500 inpatients by Pranita Tamma, an antibiotic use expert at Johns Hopkins, and colleagues, has shown. Tamma says the study clearly points to the need for clinicians to carefully assess the risk/benefit ratio when deciding antibiotics are indicated.

Tamma: The first message we need to understand is for both patients and for clinicians we need to all be on the same page, antibiotics are important, they’re great when they’re necessary, but they’re not benign.  There is harm associated with them. On the patient side, we need to do a good job of educating patients and family members that if the physician feels comfortable that the likelihood of a bacterial infection is low they’re really weighing the risks and benefits making this decision and they’re really looking out for your best interests.  :30

Tamma says many people have become accustomed to the idea that there aren’t any harms associated with antibiotic use, but her study shows that’s not the case. At Johns Hopkins, I’m Elizabeth Tracey.

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Anchor lead: About one in five people who take an antibiotic may have an adverse event, Elizabeth Tracey reports

Many people who are hospitalized receive antibiotics, but a new study by Pranita Tamma, an antibiotics use expert at Johns Hopkins, may ultimately change that. The study looked at adverse events among hospitalized patients who received antibiotics.

Tamma: Of all patients about 20% developed an antibiotic associated adverse event. Some common ones include gastrointestinal problems, low white cell count, anemia, etcetera, or kidney damage. We also had two clinicians decide whether the antibiotics were necessary or not because we wanted to get a sense of what percentage of adverse events could have been completely avoided. So looking at patients who really had no indication for antibiotics still in that group 20% went on to develop an adverse event.   :32

Tamma says this study supports the practice of not prescribing antibiotics until a need is clearly shown, and then using the most appropriate medicine for the shortest period of time. At Johns Hopkins, I’m Elizabeth Tracey.

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Anchor lead: Will personal sound amplification products change the way hearing loss is managed? Elizabeth Tracey reports

If you or a loved one has hearing loss, you may have seen ads for personal sound amplification products or PSAPs on the internet or elsewhere, and according to a study by Nicholas Reed and colleagues at Johns Hopkins and published in JAMA, many of them work very well. Reed says that points to the need to unbundle services of an audiologist from the sale of traditional hearing aids.

Reed: I think that these over the counter devices introduce the need for a la carte unbundled audiology services. what we just demonstrated in our study, you could buy something over the internet, bring it to us, and it only takes 15 minutes for us to get it working nicely for you, and then maybe another 15 minutes to show you how to use it. That’s not a lot of time on either side’s part and I think both sides could benefit from that relationship.   :23

Reed also supports federal legislation to regulate PSAPs.

Reid: If we have a regulated class, though, then those devices have to meet some standard. And at least people will be starting off on the right foot when they start with something over the counter.  :10

At Johns Hopkins, I’m Elizabeth Tracey.

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